Individual
TANISHA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1799 STUMPF BLVD STE 10, TERRYTOWN, LA 70056-3950
(504) 430-6903
Mailing address
2350 PARK PLACE DR APT 51, GRETNA, LA 70056-3074
(504) 430-6903
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/12/2016
Last updated
06/25/2019
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